Professor Peter Vajkoczy: Complex brain and spinal surgery performed to world-class standards at the Charité in Berlin

The Department of Neurosurgery at the Charité University Medical Centre in Berlin offers internationally renowned expertise in neuro-oncology, vascular neurosurgery and spinal neurosurgery.

Depending on where a brain tumour is located, treating it in a minimally invasive way and without complications can represent a huge medical challenge. Brain tumours situated in areas involved in motor functions or language are often classified as inoperable, leading to a poorer prognosis for the patients. In recent years, the Charité University Medical Centre has established numerous methods for diagnosis and treatment that allow intraoperative monitoring and enable the tumour to be localised to within the nearest millimetre and removed with precision. These methods require every member of the team to have a high level of technical expertise and experience. This applies not only to the neurosurgeons but also to the neurophysiologists, neuropsychologists, speech and language therapists and specialist neuroanaesthetists. Intraoperative monitoring involves continuous stimulation of sensitive and motor nerve paths, monitoring of the functioning of tiny cranial nerves, intraoperative monitoring of numerous language functions and monitoring of the tumour walls and supply of blood to the tumour. Language functioning is, of course, continuously tested both in German and in international patients. With such methods, it is now possible to remove around 90 per cent of these critical tumours without postoperative complications. This puts patients in a better position for further therapies and improves their overall prognosis.

Another field of our expertise is the use of vascular neurosurgery to treat complex vascular deformities (aneurysms and angiomas) and to prevent strokes caused by blood vessels closing up in the brain. A central element of this is bypass surgery. Patients from across Germany and all over the world come specifically to Berlin to have these operations carried out. In cases of complex aneurysms, which threaten to rupture a vascular wall and cause a brain haemorrhage, treatment is often required in order to close the blood vessels, performing a bypass beforehand to safeguard the supply of blood to the brain. This operation, which uses the latest minimally invasive andm laser-assisted procedures, allows us to treat patients with a low rate of complications.

Another reason for performing bypass surgery is to prevent strokes where patients are suffering from chronic closure of blood vessels in the brain. A minimally invasive bypass can significantly reduce the risk of a stroke in this situation. We also use ultramodern techniques here to identify those patients who require a bypass and then to carry out the operation rapidly and with minimum strain on the body.

In recent years, we have established stateof-the-art spinal neurosurgery methods that make it possible for minimally invasive keyhole surgery to be carried out on the spine and for the spineʼs movement to be retained. These operations are commonly used to treat narrowing of the spinal canal and instability of the spine. Patients with these conditions suffer from chronic back and leg pain, which worsens depending on the strain placed on them.

Such patients can now be treated with much less aggressive operations using the latest tube-assisted endoscopic and microsurgical procedures and without requiring major surgery on the spine or causing stiffness of the vertebrae. As a result, patients can enjoy a new quality of life, improved mobility and a reduced amount of time spent in hospital. We have also specialised in therapy for spinal disc changes that aim to retain movement in the spine. State-of-theart disc prostheses now enable operations in which spinal discs are replaced in a way that retains the natural movement of the spine after surgery and protects the other, healthy sections of the spine. This innovative procedure has helped numerous patients suffering from acute or chronic complaints in the cervical spine and lumbar spine.

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